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Global Health Security

Ten years ago this month, I was living in Bangkok, Thailand when the world was stunned by the spread of sudden acute respiratory syndrome (SARS). At that time, I was helping to establish the first International Emerging Infections Program with a small group of CDC and Thai colleagues. We saw first-hand the effects of SARS on our patients and our friends, the fear it created in the general public, and the cost to economies throughout Asia. Since then, we have experienced the H5N1 bird flu virus spread, the novel H1N1 influenza pandemic, and numerous other global disease outbreaks.

Global health security aims to protect Americans and others around the world from emerging infectious disease outbreaks – whether natural, intentional, or accidental. Through strategic investments in basic public health systems including effective and adequate laboratories, information systems, trained personnel, and effective response strategies, effective control of epidemics is possible. We have seen it happen.

Unfortunately, we tend to think about threats from emerging or man-made diseases primarily during the emergency. Although important progress has been made over the last 10 years, there is a lot that remains to be accomplished. In 2011, President Obama stressed this point to the United Nations General Assembly when he said, “To stop the disease spread across borders, we must strengthen our system of public health…we must come together to prevent, detect, and fight every kind of biological disaster whether it is a pandemic like H1N1, a terrorist threat, or a treatable disease.”

To help countries prepare to detect and respond to disease outbreaks, the World Health Organization has significantly revised the International Health Regulations (IHR). The revised IHR require countries to adequately prepare for, and respond to, public health emergencies of all types – nuclear, chemical, and radiological – whether intentional or naturally occurring. These regulations now serve as an important framework and driving force for global health security.

To help countries around the world develop and improve their ability to detect and respond to health emergencies, the CDC has important technical, research, and regulatory responsibilities within the global health security arena. For example, the Global Disease Detection (GDD) program builds country-level public health capacity for the detection and response to emerging threats through eight regional centers placed throughout the world. CDC maintains a WHO Collaborating Center for IHR Implementation of National Surveillance and Response Capacity that draws upon the efforts of many CDC programs and international partners. Since the program began in 2006, the GDD Regional Centers have supported responses to over a thousand disease outbreaks in over 50 countries. The Field Epidemiology Training Program (FETP) trains physicians and other scientists in the basics of public health investigations, forming the corps of future public health leaders with over 2,000 graduates in more than 30 countries around the world. Modeled after the U.S. Epidemic Intelligence Service, also known as “disease detectives”, FETP graduates use their skills in disease surveillance, outbreak response, and program evaluation to assist Ministries of Health in outbreak investigation and control.

These programs and many others at CDC work diligently to help build capacity and strengthen a country’s ability to improve global health security. By strengthening surveillance, laboratory diagnosis, and a country’s ability to respond to emergencies, we are not only protecting the health of people around the world, we are also protecting the people here at home.

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